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ETHAN M GRUMBACH PH.D.
NPI 1104955681
Social Worker - Clinical in Los Angeles, CA

Active since March 02, 2007Opted out of Medicare · through Jan 1, 2028
948 S CITRUS AVE, LOS ANGELES, CA 90036(323) 933-3536(323) 937-4070 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ethan M Grumbach Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN M GRUMBACH PH.D. (NPI 1104955681) is an individual clinical provider in Los Angeles, California, licensed in California (LCS19239) and active in the NPI registry since March 2007. He has opted out of Medicare through January 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1104955681
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameETHAN M GRUMBACHCredential: PH.D.
Location Address948 S CITRUS AVELos Angeles, CA 90036-4929
Mailing Address948 S Citrus AveLos Angeles, CA 90036-4929 · (323) 933-3536 · Fax (323) 937-4070
Phone(323) 933-3536
Fax(323) 937-4070
Sole ProprietorYes
Enumeration DateMarch 2, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1104955681 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · LCS19239
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
948 S CITRUS AVE, Los Angeles, CA 90036
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ethan M Grumbach Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2018 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2018
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90036 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $62.96 – $187.60
Typical copayment $0.00 (range $15.74 – $46.90)
Most-billed visit code NA
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Grumbach's NPI number?

The NPI number for Ethan Grumbach is 1104955681. It was assigned to this individual provider in the NPPES registry on March 2, 2007.

Where is Ethan Grumbach located?

Ethan Grumbach practices at 948 S Citrus Ave, Los Angeles, CA 90036. The listed phone number is (323) 933-3536.

What is Ethan Grumbach's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Ethan Grumbach enrolled in Medicare?

No. Ethan Grumbach has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Ethan Grumbach was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.